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Primary Healthcare Workers' Awareness of Acute Rheumatic Fever & Rheumatic Heart Disease: A Study in Public Health
Moses Ochora1, Lydia Kyasimire1, Dan Lutasingwa1
1Department of Paediatrics and Child Health, Mbarara University of Science and Technology, Mbarara City, Uganda.
Insights
Primary health workers in Uganda show low knowledge of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) care. Improving training is crucial to prevent serious complications in children with streptococcal infections.
Area of Science:
- Public Health
- Infectious Diseases
- Cardiology
Background:
- Streptococcal throat infections can lead to acute rheumatic fever (ARF) and rheumatic heart disease (RHD).
- Early identification and treatment are vital to prevent progression to RHD, especially in developing countries.
- Children in these regions often present with advanced RHD due to inadequate care for sore throats and ARF.
Purpose of the Study:
- To assess the knowledge, skills, and practices of primary healthcare workers in South Western Uganda regarding the care of children with sore throat, ARF, and RHD.
- To identify gaps in the understanding and management of these conditions among healthcare providers.
Main Methods:
- A comparative quantitative cross-sectional study was conducted.
- Eighty health workers from public and private facilities in Mbarara district were interviewed.
- Responses were scored against a structured guide, and data were analyzed using Fisher's exact test and chi-squared test.
Main Results:
- While 95% of health workers had awareness of ARF and RHD, only 43.75% possessed good knowledge.
- A significant majority (61.25%) lacked knowledge of proper prophylaxis and investigations for ARF.
- No statistically significant differences in knowledge levels were found between public and private facilities.
Conclusions:
- The knowledge and skill levels of primary healthcare workers in South Western Uganda concerning ARF and RHD are low.
- There is a need for enhanced training and education for health workers to improve the management of streptococcal infections and prevent ARF/RHD.
- Consistent knowledge gaps exist across both public and private healthcare sectors.
Introduction:
Timely identification and treatment of a streptococcal throat infection prevents acute rheumatic fever (ARF) and its progression to Rheumatic Heart Disease (RHD). However, children in developing countries still present with established RHD, due to either missed, untreated or sub-optimally treated sore throats and ARF. We aimed to determine the level of knowledge, skills, and practices of primary health workers in South Western Uganda in providing care such children.
Methods:
We conducted a comparative quantitative cross-sectional study to assess knowledge, practices, and skills regarding the care of a child with a sore throat, ARF, and RHD. The responses were scored against a structured guide. The Fisher's exact test and the chi-squared test with level of significance set at 0.05 were utilized to compare differences in knowledge, skills, and practices among health workers in private and public health facilities about ARF and RHD.
Results:
Eighty health workers from health facilities were interviewed in Mbarara district with a median age of 29.5 years (IQR 27.34) and median duration in practice of 5 years (IQR: 2, 10). On average, there were at least 3 children with sore throats weekly. At least 95% (CI: 87.25%-98.80%) of the health worker had awareness about ARF and RHD. Only 43.75% (95% CI: 33.18%-54.91%) had good knowledge about ARF and RHD. Majority, 61.25% (95% CI: 50.03%-71.39%) did not know the proper prophylaxis and investigations for a child with ARF. There were no statistically significant differences but a clinically meaningful differentials in the level of knowledge among health workers in public and private facilities.
Conclusion:
The knowledge and skill level of health workers in primary healthcare facilities about ARF and RHD in South Western Uganda remains low, with no difference between practitioners in public and private facilities.
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